We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Review |

Orbital Complications of Acute Sinusitis in Infants A Systematic Review and Report of a Case

Saurabh Sharma, MD1; Gary D. Josephson, MD, MBA2
[+] Author Affiliations
1Department of Otolaryngology–Head and Neck Surgery, University of South Florida, Tampa
2Pediatric Otolaryngology–Head and Neck Surgery, Nemours Children’s Clinic, Jacksonville, Florida
JAMA Otolaryngol Head Neck Surg. 2014;140(11):1070-1073. doi:10.1001/jamaoto.2014.2326.
Text Size: A A A
Published online

Importance  Orbital infections from acute sinusitis are rare in neonates and infants and can lead to devastating complications. To our knowledge, no prior dedicated review exists for evaluation, treatment, and outcomes of orbital complications in this age group.

Objective  To perform a systematic review over the past 50 years on the diagnosis and treatment of orbital complications secondary to acute sinusitis in neonates and infants and report a case.

Evidence and Acquisition  A systematic review of the literature was performed searching PubMed to collect all the pertinent case reports and series in the English language with subperiosteal orbital abscess (SPOA) or orbital abscess in neonates or infants (date range, 1959-2012).

Results  Eleven cases of SPOA in infants were identified, including our current case. Ages ranged from 10 to 74 days. There were 6 female and 5 male infants. The right eye was affected in 5 cases, the left in 5, and both in 1. There was 1 mortality in this series for which surgical drainage was not performed. Staphylococcus aureus was the most common organism isolated in 9 of 11 cases. Seven of the cases had open surgical drainage, 2 had endoscopic procedures (including our case), and 1 had spontaneous rupture of the abscess.

Conclusions and Relevance  An orbital complication due to acute sinusitis is rare in infants and neonates. Drainage in this patient population appears to be paramount, since the only infant in this series who did not receive drainage had died. Modern telescopes and equipment have allowed endoscopic drainage to be a safe and effective surgical treatment in this age group.

Figures in this Article


Place holder to copy figure label and caption
Preoperative CT and Intraoperative Images

A, Axial view of the computed tomographic (CT) scan of the sinus with contrast delineating the subperiosteal abscess in the left orbit. B, Intraoperative image showing total ethmoidectomy performed on the left with purulent drainage noted after removal of the medial orbital wall.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles